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Elimination of Hepatitis C in Scotland

10 September, 2019


Leon Wylie, Head of Hepatitis Scotland, comments on the progress towards elimination of hepatitis C in Scotland, and the challenges still needing to be overcome to achieve this.

When doing background reading for this blog I realised that even after the Scottish Government announcement committing to elimination we are still at a similar point as last year. The Three Asks for Elimination presented to the First Minister in July 2018 by the HepCScot campaign very much provide a roadmap to where we want to be as a country by 2024.

Eliminating hepatitis C as a public health concern in Scotland can help transform the lives of those affected and there is an incredible opportunity to improve the health of Scotland’s communities. Without making progress towards elimination, many people currently living with, or at risk of hepatitis C, will continue to face health inequalities or greater morbidity linked to issues such as mental health, drug and alcohol use. These health inequalities not only have a damaging impact on individuals’ health and wellbeing, but will still often act as a barrier to accessing blood borne virus testing and support.

It is vital that work continues to identify, test and support people into treatment, not only for those most in need but anyone who has a chronic infection. Reducing the impact of hepatitis C on the health and wellbeing of individuals can only be achieved if those most at risk of harm are diagnosed and treated quickly. 2016 marked the first year in Scotland where the number of people starting hepatitis C treatment was greater than the number of new diagnoses. This must be repeated consistently if we are to achieve hepatitis C elimination. This will require high and sustained rates of both diagnosis and treatment.

The rolling out of treatment from centralised services to community and outreach services and primary care enables community engagement by going to where people are. Integrating testing and treatment in community-based services enhances access and increases opportunities for peer education and support. Using peers as educators and support may also help overcome systemic and cultural barriers.

Public health disinvestment and stigmatising practices for people accessing sterile injecting equipment or opiate substitute therapy disempowers and puts at risk both a population and a health programme. Re-infection rates and transmission of resistant variants of virus will not be solely addressed by increasing treatment rates. An evidenced cost-effective approach is assuring provision of low threshold, easy to access harm reduction services and education for all who require it. Such services support people in their recovery, not only from hepatitis C itself, but also from associated challenges including addiction and mental health. A refresh of the Injecting Equipment Provision guidelines will provide a roadmap but as a community we must be willing to follow those directions.

The Scottish Government addressing elimination of hepatitis C in Scotland is an important opportunity. Scotland can demonstrate how the proposed whole system approach can positively affect those in most need and lead the way for doing the same for similar health and social issues.

 

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This campaign is a partnership in Scotland between:

Hepatitis ScotlandWaverley CareAddactionPositive HelpThe Hepatitis C Trust

Our NHS partners are:

In partnership with NHS GrampianIn partnership with NHS Greater Glasgow and ClydeIn partnership with NHS LanarkshireIn partnership with NHS LothianIn partnership with NHS Forth ValleyIn partnership with NHS FifeIn partnership with MCN

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Or call NHS Inform’s Hepatitis helpline:
0800 22 44 88 (Open: 8am-10pm)